Asking doctors to order a Decipher test

Adt is orgavux diagnosed at 70yrs old

I sure would like to know what my decipher score is if I had a Gleason eight and a high PSA, 47 is relatively high though I know that people can be up to the many thousands.

Some medical systems do it for almost everybody.

I was diagnosed and treated 16 years ago so it’s a little too late, And since I have BRCA2, it’s irrelevant, I will have reoccurrences no matter what.

One question is, will your insurance company pay for it, medicare does cover it.

I suspect that your PSA > 40, Gleason score of 8 and the presence of SVI classifies you as being what NCCN Guidelines define as being at Very High Risk of recurrence, progression and metastasis. When I was diagnosed as a Gleason 9, the oncologists I used reviewed the NCCN Guidlines for Prostste Cancer risk clsssification and treatment with me. Then, as know, the guidelines and quarterly updates were/are essential to understanding the consensus treatment opinions of the best PCa oncologists in the country. As a Gleason 9 with 2 high risk features at diagnosis, was told that the Decipher Test wouldn't alter my treatment options.

Congratulations on your undetectable PSA. May it continue.

Ty all for your comments - very helpful

My decipher test was billed to my insurance at $5000. I don't know what they paid. Whoever pays wants to know why they should pay.

The company that created it says it is indicated to aid a treatment decision. Once you've been treated, apparently successfully, the test a clinician is interested in is something that will indicate if the cancer has recurred. A $50 PSA test can do that.

You might feel better because a decipher test indicated a low risk, or you might feel worse if it indicated high risk, but they won't treat you any differently now that you are at the monitoring stage. So getting insurance companies to pay for something that won't alter how clinicians treat you or alter the course of your disease, because you might feel better or not, sounds unlikely.

I think @climateguy nailed it and you might be at the "not medically necessary" phase of this request which is why your providers are reluctant to order it.

Was the request after the biopsy or after treatment? The test is justified to help determine the course of treatment. Will insurance pay after treatment if there is no recurrence? Do they still have the tissue from the biopsy for the test? Is the tissue still viable (test usually done within a couple of months after the biopsy)? If you made the request for the Decipher before treatment, I do not understand the reluctance. If after treatment it may be due to issues with samples or payment.